Organization
ALBUQUERQUE HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIVAN WILSON PSYD (CEO)
(505) 260-9917
Entity
Organization
Contact information
Practice address
172 MONTANO RD NW, ALBUQUERQUE, NM 87107-5030
(505) 344-4427
Mailing address
172 MONTANO RD. NW, ALBUQUERQUE, NM 87107
(505) 344-4427
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
03/17/2010
Last updated
07/06/2021
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